Mitchem, Randall E
Mitchem, Randall E is an individual health care provider with primary practice located at 5301 Faraon St Suite 210, Saint Joseph MO 64506-3373. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Mitchem, Randall E can be contacted via phone (816) 271-1385.Contact Information
Primary practice address
5301 Faraon St Suite 210
Saint Joseph MO 64506-3373
Phone: (816) 271-1385
Fax: (816) 271-1379
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | R6J49 | Missouri |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | R6J49 | Missouri |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | R6J49 | Missouri |
Profile Details
| NPI number | 1609808781 |
|---|---|
| LBN Legal business name | Mitchem, Randall E |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Nov 21st, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609808781 | NPPES |
| Missouri | MEDICAID | 205865009 | |
| Missouri | Other | 2104655 | |
| Missouri | MEDICAID | 100233020B | |
| Missouri | Other | 403991 | |
| Missouri | Other | 10001363800 | |
| Missouri | Other | 25862028 |
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